Document Detail


Coronary artery constriction caused by the cold pressor test in human hypertension.
MedLine Citation:
PMID:  8039846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertensive patients with angiographically normal coronary arteries may have myocardial ischemia when metabolic demand increases. Abnormal epicardial coronary artery vasomotion in response to sympathetic stimulation may contribute to ischemia in such patients. We studied the vasomotor response of smooth coronary arteries to a cold pressor test in 10 hypertensive patients without other risk factors and in 9 control subjects. Vessel dimensions were measured by quantitative angiography, and blood flow was calculated using an intracoronary Doppler catheter in the left anterior descending coronary artery. In response to cold pressor stimulation, arteries of control subjects dilated 13.0 +/- 5.9% (P < .001), and they constricted 8.2 +/- 8.5% in hypertensive patients (P < .001). Rate-pressure product increased from 9466 +/- 1677 to 12,547 +/- 2367 beats per minute (bpm).mm Hg in control subjects (P < .001) and from 13,720 +/- 1823 to 17,353 +/- 2037 bpm.mm Hg in hypertensive patients (P < .001). Coronary blood flow velocity and blood flow increased 51 +/- 26% (P < .05) and 87 +/- 27% (P < .001), respectively, in control subjects and 68 +/- 52% (P < .05) and 36 +/- 33% (P < .01) in hypertensive patients. At peak cold pressor test, despite a significant higher rate-pressure product in hypertensive patients, blood flow was similar in both groups, suggesting an uncoupling between myocardial metabolic demand and supply. Thus, hypertension impairs the vasodilator response of angiographically normal coronary arteries to a cold pressor test. This abnormal response may be due to enhanced catecholamine reactivity and/or impairment of endothelial flow-mediated vasodilator response.
Authors:
I Antony; E Aptecar; G Lerebours; A Nitenberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hypertension     Volume:  24     ISSN:  0194-911X     ISO Abbreviation:  Hypertension     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1994-08-25     Completed Date:  1994-08-25     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  212-9     Citation Subset:  IM    
Affiliation:
Service d'Explorations Fonctionnelles, Centre Hospitalier et Universitaire Xavier Bichat, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cold Temperature
Coronary Angiography
Coronary Circulation / drug effects
Coronary Vessels / physiopathology*
Endothelium, Vascular / physiology
Female
Humans
Hypertension / physiopathology*
Isosorbide Dinitrate / pharmacology
Male
Middle Aged
Sympathetic Nervous System / physiology
Vasoconstriction* / drug effects
Chemical
Reg. No./Substance:
87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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